Abdominal Pain and Masses

Question 1

Generalised abdo pain causes:

GI causes

Non-GI

What must be remembered in reality?

Answer 1

Organ perforation and/or generalised peritonitis
Ruptured AAA
Acute mesenteric ischaemia
GE

DKA
Addison’s
Functional/IBS

In practice, many patients will describe the pain as general even though it is localised

Question 2

RUQ pain causes - list some causes

Answer 2

Gallbladder disease 
Duodenal ulcer 
Liver disease 
Subphrenic abscess 
Right lower lobe pneumonia

Question 3

Epigastric pain causes - list some causes

Answer 3

GORD
Peptic ulcer disease (PUD), including perforation.
Pancreatitis. Distinguished from perforated PUD by lots of vomiting.
AAA
Acute cholecystitis.
Gastric cancer.
MI
Gastroenteritis

Question 4

Left upper quadrant - list some cause

Answer 4

Gastric ulcer.
Acute pancreatitis.
Ruptured spleen.
Subphrenic abscess.
Left lower lobe pneumonia.

Question 5

Left and right flank - list some causes

Answer 5

Pyelonephritis. Radiates to back.

Renal or ureteric stones. Causes renal colic, a severe, waxing and waning pain which radiates from loin to groin.

Question 6

Umbilical - list some causes

Answer 6

Intestinal obstruction.
Early appendicitis.
AAA
Gastroenteritis

Appendicitis
Meckel's or cecal diverticulitis.
Crohn's
Ruptured ectopic.
Strangulated hernia.
Genitourinary problems.
Mesenteric adenitis.
Psoas abcess.

Question 7

Right lower quadrant - list some causes

Answer 7

Appendicitis
Meckel's or cecal diverticulitis.
Crohn's
Ruptured ectopic.
Strangulated hernia.
Genitourinary problems.
Mesenteric adenitis.
Psoas abcess.
Suprapubic
Gynae: UTI, PID, ectopic, ovarian tumour, endometriosis.
Bladder: retention, cancer.

Question 8

Suprapubic - list some causes

Answer 8

Gynae: UTI, PID, ectopic, ovarian tumour, endometriosis.
Bladder: retention, cancer.

Question 9

Left lower quadrant - list some causes

Answer 9

Constipation
Ulcerative colitis (crampy).
IBS
Sigmoid diverticulitis
Rectal cancer.
Ischaemic colitis.
Ruptured ectopic.
Strangulated hernia.
Genitourinary problems.